OXYGEN-SATURATION DURING ESOPHAGOGASTRODUODENOSCOPY IN CHILDREN - GENERAL-ANESTHESIA VERSUS INTRAVENOUS SEDATION

Background: Hypoxia may occur in children undergoing upper digestive e ndoscopy under sedation. The purpose of this study was to compare the occurrence of desaturation during intravenous sedation with that which occurs during general anesthesia. Methods: Thirty-six patients betwee n 3 months and 6 years old underwent a diagnostic esophagogastroduoden oscopy under sedation (n = 18) or general anesthesia (n = 18). Oxygen pulse oximetry, heart rate, and mean arterial pressure were monitored throughout the procedure. At the end of the procedure, the operator ga ve the value of the endoscopy satisfaction score on a scale of I (very good conditions) to TV (impossible procedure). Results: The minimum o xygen pulse oximetry value was significantly lower in the sedation gro up compared with that in the general anesthesia group (89 +/- 5 vs. 97 +/- 1; p < 0.001). In the general anesthesia group, the oxygen pulse oximetry level declined to less than 95% in only one child; but in the sedation group, it declined to less than 95% in 16 patients (5.5% vs. 89%). Nine patients had a profound desaturation in sedation group (ox ygen pulse oximetry < 90%); no patients in the general anesthesia grou p had desaturation (50% vs. 0%). In the general anesthesia group, hear t rate and mean arterial pressure remained stable during the whole pro cedure, whereas in the sedation group, heart rate and mean arterial pr essure increased significantly during the procedure. The endoscopy sat isfaction score was I in all 18 patients in the general anesthesia gro up, whereas in the sedation group, it was I in only 2 patients, II in 8 patients, and III in 10 patients. Conclusions: These results confirm that hypoxia during upper digestive endoscopy in patients under sedat ion is a frequent occurrence in children. When compared with sedation, general anesthesia is a safer technique that prevents hypoxia and all ows the gastroenterologist to perform the endoscopy under better condi tions.